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Adverse Impact of Intraoperative Conversion on the Postoperative Course Following Laparoscopic Pancreaticoduodenectomy

Authors
 Law Cho Kwan Connie  ;  Seung Soo Hong  ;  Incheon Kang  ;  Seung Yoon Rho  ;  Ho Kyoung Hwang  ;  Woo Jung Lee  ;  Chang Moo Kang 
Citation
 YONSEI MEDICAL JOURNAL, Vol.62(9) : 836-842, 2021-09 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2021-09
MeSH
Humans ; Laparoscopy* / adverse effects ; Length of Stay ; Pancreatectomy ; Pancreaticoduodenectomy* / adverse effects ; Retrospective Studies
Keywords
Laparoscopic ; complication ; conversion ; morbidity ; pancreaticoduodenectomy
Abstract
Purpose: The aim of the current study was to evaluate the adverse clinical impact of intraoperative conversion during laparoscopic pancreaticoduodenectomy (LPD).

Materials and methods: The medical records of patients who underwent pancreaticoduodenectomy (PD) were retrospectively reviewed. Perioperative clinical variables were compared between patients who underwent converted PD (cPD) and initially planned open PD (OPD) to investigate the clinical impact and predictive factors of intraoperative conversion during LPD.

Results: A total of 171 patients were included. Among them, 31 patients (19.3%) were found to have intraoperative conversion during LPD. Failure of progression due to severe adhesion (12 patients, 7%) and major vessel invasion (7 patients, 4%) were the two most frequent reasons for conversion. On multivariate analysis, age [Exp(β)=1.044, p=0.044] and pancreatic texture [Expa(β)=2.431, p=0.039) were found to be independent factors for predicting intraoperative conversion during LPD. In comparative analysis with the OPD group, the cPD group had a longer operation time (516.8 min vs. 449.9 min, p=0.001), higher rate of postoperative hemorrhage (12.1% vs. 0.85%, p=0.008), higher reoperation rate (9.1% vs. 0%, p=0.01), and higher cost (21886.4 USD vs. 17168.9 USD, p=0.018).

Conclusion: Intraoperative conversion during LPD can have an adverse clinical impact on the postoperative course following LPD. Appropriate patients selection and improvement of surgical techniques will be crucial for unnecessary intraoperative conversion and safe LPD.
Files in This Item:
T202103661.pdf Download
DOI
10.3349/ymj.2021.62.9.836
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Rho, Seoung Yoon(노승윤) ORCID logo https://orcid.org/0000-0002-1265-826X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hong, Seung Soo(홍승수)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184784
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